Evidence map›Paper›PMID 39689188›Full record

Trial reportCirculation. Cardiovascular interventions2024

Relationship Between Severity of Ischemia and Coronary Artery Disease for Different Stress Test Modalities in the ISCHEMIA Trial.

Harmony R Reynolds, Courtney B Page, Leslee J Shaw, Daniel S Berman, Bernard R Chaitman, Michael H Picard, Raymond Y Kwong, James K Min, Jonathon Leipsic, G B John Mancini and 27 more

Registry-linked trialAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation. Cardiovascular interventions, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01471522 (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01471522 nacompletednot on this map

International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA)

TypeinterventionalSponsorNYU Langone HealthRan2012 to 2023Enrolled5,179ConditionsCardiovascular Diseases, Coronary Disease, Coronary Artery Disease, Heart DiseasesArmscardiac catheterization, coronary artery bypass graft surgery, percutaneous coronary intervention, Lifestyle, Medication
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

37 authors.

Harmony R ReynoldsCardiovascular Clinical Research Center, Department of Medicine, NYU Grossman School of Medicine, New York, NY (H.R.R., L.P., S.B., J.S.H.).ORCID 0000-0003-0284-0655
Courtney B PageDuke Clinical Research Institute, Durham, NC (C.B.P., D.B.M., K.P.A., S.M.O.).ORCID 0000-0001-7671-3355
Leslee J ShawIcahn School of Medicine at Mount Sinai, New York, NY (L.J.S., G.W.S.).ORCID 0000-0003-1268-1491
Daniel S BermanCedars-Sinai Medical Center, Los Angeles, CA (D.S.B.).ORCID 0000-0002-3793-9578
Bernard R ChaitmanSt. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, MO (B.R.C.).ORCID 0000-0002-9216-5317
Michael H PicardDepartment of Medicine, Cardiovascular Division, Massachusetts General Hospital, Boston (M.H.P.).ORCID 0000-0002-9264-3243
Raymond Y KwongDepartment of Medicine, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (R.Y.K.).
James K MinCleerly, Inc, New York, NY (J.K.M.).
Jonathon LeipsicCenter for Cardiovascular Innovation (J.L., G.B.J.M.), The University of British Columbia, Vancouver, Canada.ORCID 0009-0002-3892-9029
G B John ManciniCenter for Cardiovascular Innovation (J.L., G.B.J.M.), The University of British Columbia, Vancouver, Canada.ORCID 0000-0002-2419-1476
Matthew J BudoffLundquist Institute, Los Angeles, CA (M.J.B.).ORCID 0000-0002-9616-1946
Cameron J HagueSt. Paul's Hospital Department of Radiology (C.J.H.), The University of British Columbia, Vancouver, Canada.
Roxy SeniorNorthwick Park Hospital-Royal Brompton Hospital, London, United Kingdom (R.S.).ORCID 0000-0001-6579-7039
Hanna SzwedNational Institute of Cardiology, Warsaw, Poland (H.S.).
Balram BhargavaAll India Institute of Medical Sciences, New Delhi, India (B.B.).
Jelena CelutkieneClinic of Cardiac and Vascular Diseases, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Lithuania (J.C.).ORCID 0000-0003-3562-9274
Milind GadkariKEM Hospital, Maharashtra, India (M.G.).
Kevin R BaineyMazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (K.R.B.).ORCID 0000-0002-5458-4617
Rolf DoerrPraxisklinik Herz und Gefäße, Dresden, Germany (R.D.).ORCID 0000-0002-6599-2958
Ruben B RamosHospital de Santa Marta, Lisboa, Portugal (R.B.R.).ORCID 0000-0003-0736-3878
Peter OngDepartment of Cardiology and Angiology, Robert-Bosch-Hospital, Stuttgart, Germany (P.O.).
Sudhir R NaikApollo Health City Campus, Hyderabad, India (S.R.N.).
Philippe Gabriel StegAssistance Publique-Hopitaux de Paris, Universite de Paris, France (P.G.S.).ORCID 0000-0001-6896-2941
Kaatje GoetschalckxDepartment of Cardiovascular Disease, UZ Leuven, Belgium (K.G.).ORCID 0000-0002-5419-7684
Benjamin J W ChowDepartments of Medicine (Cardiology) and Radiology, University of Ottawa Heart Institute, ON, Canada (B.J.W.C.).ORCID 0000-0001-8631-0234
Marielle Scherrer-CrosbieDivision of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia (M.S.-C.).ORCID 0000-0001-6375-9266
Lawrence PhillipsCardiovascular Clinical Research Center, Department of Medicine, NYU Grossman School of Medicine, New York, NY (H.R.R., L.P., S.B., J.S.H.).
Daniel B MarkDuke Clinical Research Institute, Durham, NC (C.B.P., D.B.M., K.P.A., S.M.O.).ORCID 0000-0001-6340-8087
John A SpertusHealthcare Institute for Innovations in Quality and Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, MO (J.A.S.).ORCID 0000-0002-2839-2611
Karen P AlexanderDuke Clinical Research Institute, Durham, NC (C.B.P., D.B.M., K.P.A., S.M.O.).ORCID 0000-0003-4418-1424
Sean M O'BrienDuke Clinical Research Institute, Durham, NC (C.B.P., D.B.M., K.P.A., S.M.O.).
William E BodenVA New England Healthcare System, Boston, MA (W.E.B.).ORCID 0000-0001-7145-8084
Sripal BangaloreCardiovascular Clinical Research Center, Department of Medicine, NYU Grossman School of Medicine, New York, NY (H.R.R., L.P., S.B., J.S.H.).ORCID 0000-0001-9485-0652
Gregg W StoneIcahn School of Medicine at Mount Sinai, New York, NY (L.J.S., G.W.S.).ORCID 0000-0002-3416-8210
David J MaronDepartment of Medicine, Stanford University School of Medicine, CA (D.J.M.).ORCID 0000-0002-4867-8588
Judith S HochmanCardiovascular Clinical Research Center, Department of Medicine, NYU Grossman School of Medicine, New York, NY (H.R.R., L.P., S.B., J.S.H.).ORCID 0000-0002-5889-5981
ISCHEMIA Research Group

Funding

Project-005UL1TR001445 · NCATS · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI BREDELLA, MIRIAM ANTOINETTE, HOCHMAN, JUDITH S · 2015 to 2025
$103.5M
The Ischemia Trial - CCCU01HL105907 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI HOCHMAN, JUDITH S · 2011 to 2019
$100.1M
The ISCHEMIA Trial - SDCCU01HL105462 · NHLBI · DUKE UNIVERSITY · PI ALEXANDER, KAREN P, O'BRIEN, SEAN M · 2011 to 2019
$17.8M
THE ISCHEMIA TRIAL - IICCU01HL105561 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI SHAW, LESLEE J · 2011 to 2018
$6.5M
The ISCHEMIA Trial - EQOLU01HL105565 · NHLBI · DUKE UNIVERSITY · PI MARK, DANIEL B · 2011 to 2017
$2.4M
NCATS NIH HHS UL1 TR001445NHLBI NIH HHS U01 HL105462NHLBI NIH HHS U01 HL105561NHLBI NIH HHS U01 HL105565NHLBI NIH HHS U01 HL105907
6 · The paper itself

Abstract

backgroundThe relationship between the extent and severity of stress-induced ischemia and the extent and severity of anatomic coronary artery disease (CAD) in patients with obstructive CAD is multifactorial and includes the intensity of stress achieved, type of testing used, presence and extent of prior infarction, collateral blood flow, plaque characteristics, microvascular disease, coronary vasomotor tone, and genetic factors. Among chronic coronary disease participants with site-determined moderate or severe ischemia, we investigated associations between ischemia severity on stress testing and the extent of CAD on coronary computed tomography angiography.

methodsClinically indicated stress testing included nuclear imaging, echocardiography, cardiac magnetic resonance imaging, or nonimaging exercise tolerance test. Among those with preserved renal function who underwent coronary computed tomography angiography, we examined relationships between ischemia and CAD by coronary computed tomography angiography, overall, and by stress test modality, regardless of subsequent randomization. Core laboratories categorized ischemia as severe, moderate, mild, or none, while the extent and severity of anatomic CAD were categorized based on the modified Duke prognostic index.

resultsAmong 3601 participants with interpretable stress tests and coronary computed tomography angiography, ischemia severity was weakly associated with CAD extent/severity (r=0.27), with modest variability in strength of association by modality: nuclear (n=1532; r=0.40), echocardiography (n=827; r=0.15), cardiac magnetic resonance imaging (n=108; r=0.31), and exercise tolerance test (n=1134; r=0.18). The extent of infarction on nuclear imaging and echocardiography was weakly associated with CAD extent/severity.

conclusionsOverall, ischemia severity on stress testing showed weak to moderate associations with the anatomic extent of CAD in this cohort with moderate or severe ischemia on local interpretation and controlled symptoms. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01471522.

Indexed as

Computed Tomography AngiographyCoronary AngiographyCoronary Artery DiseaseExercise TestPredictive Value of TestsSeverity of Illness IndexAgedEchocardiography, StressExercise ToleranceFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedMyocardial IschemiaMyocardial Perfusion Imagingangiographycoronary artery diseaseinfarctionischemiaplaque, atherosclerotic

Identifiers

PMID39689188
PMCPMC11658795

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.